Fraxiparin: Mankhwala amasulidwe ndi mtengo

Kufotokozera kogwirizana ndi 29.12.2014

Dzina lachi Latin: Fraxiparine
Code ya ATX: B01AB06
Chithandizo: Calcium calcium ya Nadroparin (calcium ya Nadroparin)
Wopanga: GLAXO WELLCOME PRODUCTION (France)

1 syringe ya mankhwala a Fraxiparin akhoza kukhala ndi 9500, 7600, 5700, 3800 kapena 2850 IU anti-Xa calcium ya nadroparin.

Zowonjezera: hydrochloric acid kapena yankhocalcium hydroxidemadzi.

Pharmacodynamics ndi pharmacokinetics

Mankhwala

Kulemera pang'ono kwa maseloheparinmankhwala opangidwa ndi depolymerization kuchokera ku heparin wokhazikika glycosaminoglycan okhala ndi kulemera kwakukulu kwa ma 4300 dalton.

Amakhala ndi kutentha kwakukulu kwa mapuloteni amwazi antithrombin 3, zomwe zimatsogolera ku kuponderezana kwa factor Xa - izi zimachitika makamaka chifukwa cha omwe amatchulidwa antithrombotic zotsatira nadroparin.

Ntchito: minofu chinthu kusinthika blocker, fibrinolysis ndi kumasulidwa mwachindunji minofu stimulant plasminogenkuchokera ku endothelial minofu, kusintha kwa magawo aminyewa yamagazi (kuchepa kwa mamasukidwe amwazi ndi kuwonjezeka kwa kupezekanso kwa nembanemba kwamaselo am'maselo am'magazi ndi maselo a granulocyte).

Poyerekeza heparin wosakhazikika imakhala yofooka pakugwira ntchito yam'mapulatifomu, kuphatikizira ndi hemostasis yoyamba.

Munthawi yamankhwala omwe mumalandira chithandizo chokwanira ndi ntchito yambiri, kuchuluka kwa APTT kwa nthawi 1.4 zomwe muyezo ndizotheka. Mlingo wa prophylactic, sizimapangitsa kuchepa kwamphamvu kwa APTT.

Pharmacokinetics

Pambuyo pa jekeseni wa subcutaneous, ntchito yapamwamba kwambiri ya anti-Xa, ndiye kuti, kuchuluka kwambiri m'magazi kumatha pambuyo pa maola 4-5, pafupifupi kutengeka kwathunthu (mpaka 88%). Ndi jakisoni wovomerezeka, ntchito yapamwamba kwambiri ya anti-Xa imachitika pakatha mphindi 10. Kuthetsa theka-moyo wafika 2 maola. Komabe, katundu wa anti-Xa amawonekera kwa maola osachepera 18.
Wopangidwira m'chiwindi kuwonongedwa ndi depolymerization.

Zizindikiro zogwiritsidwa ntchito

Chenjezothromboembolic zovuta(atagwira ntchito zamatumbo ndi maopareshoni, mwa anthu omwe ali pachiwopsezo chachikulu cha thrombosis, akuvutika mtima kapena kulephera kupumamtundu pachimake).

Contraindication

Kupuma kapena chiwopsezo chake chowonjezereka chokulirakulira makulidwe.
Supombocytopenia akamadyedwa nadroparinm'mbuyomu.
Vuto lowonongeka ndi chiopsezo chotaya magazi.
Zaka mpaka 18.
Zovuta kulephera kwa aimpso.
Intracranial hemorrhage.
Kuvulala kapena kugwira ntchito pa chingwe cha msana ndi ubongo kapena pazitsetse zamaso.
Lakuthwa matenda endocarditis.
Hypersensitivity ku zigawo za mankhwala.

Gwiritsani ntchito mosamala mukamachita: otupa kapena Kulephera kwaimpso, matenda oopsakwambiri, ndi zilonda zam'mimbam'mbuyomu kapena matenda ena okhala ndi chiopsezo chambiri kutuluka kwa magazi, kusintha kwa magazi m'magazi a choreid ndi retina, atachitidwa opaleshoni, odwala omwe ali ndi makilogalamu 40, ngati nthawi ya chithandizo imaposa masiku 10, osagwirizana ndi ma regimens othandizira, akaphatikizidwa ndi zina anticoagulants.

Zotsatira zoyipa

Zochitika mu njira yozizira: Kukhetsa magazi kosiyanasiyana.
Zotsatira za hematopoietic system: thrombocytopenia, eosinophilia.
Machitidwe a Hepatobiliary: kuchuluka kwambirimichere ya chiwindi.
Zokhudza chitetezo chamthupi: Hypersensitivity zimachitikira.
Zomwe zimachitika mdera: Kapangidwe kakang'ono kwambiri hematomas m'malo a jakisoni, mawonekedwe a mitundu yolimba yomwe imasowa patatha masiku angapo, necrosis khungu m'malo oyang'anira. Muzochitika izi, chithandizo cha mankhwala a Fraxiparin chiyenera kuyimitsidwa.
Zotsatira zina: Hyperkalemia, priapism.

Bongo

Chithandizo: Kuchepetsa magazi sikufunikira chithandizo (chotsitsa mlingo kapena chepetsani jakisoni wotsatira). Protamine Sulfate satenga anticoagulant machitidwe heparin. Kugwiritsidwa ntchito ndikofunikira pokhapokha ngati pali milandu yayikulu. Muyenera kudziwa kuti 0,6 ml protamine sulfate neutralates pafupifupi 950 anti-Ha ME nadroparin.

Kuchita

Kuopsa mwadzidzidzi Hyperkalemiazimawonjezeka zikaphatikizidwamchere wa potaziyamu, zoletsa za ACE, zoteteza potaziyamu, angiotensin receptor blockers, heparins, mankhwala osokoneza bongo a anti-yotupa, tacrolimus, cyclosporine, trimethoprim.

Ntchito zophatikizika ndi acetylsalicylic acid, anticoagulants osadziwika, NSAIDs, fibrinolytics kapena dextran imalimbikitsa zolimbitsa zovuta zamankhwala.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fraxiparin imapezeka ngati yankho la subcutaneous (s / c) kayendetsedwe kabwino: kotsekemera kapenanso kowoneka bwino pang'ono, kaso kopanda kuwala kapena kaso pang'ono (pamwala wa 0,3 ml, 0,4 ml, 0,6 ml, 0,8 ml kapena 1) ml mu ma syringes otayidwa mu galasi, ma syringe awiri mu chithuza, pamatabwa a 1 kapena 5 matuza.

1 ml yankho lili:

yogwira mankhwala: calcium nadroparin - 9500 ME (gawo lapadziko lonse) anti-Xa,
othandizira: calcium hydroxide solution (kapena kuchepetsa hydrochloric acid), madzi a jakisoni.

Mu syringe 1, calcium ya nadroparin imadalira kuchuluka kwake ndipo imagwirizana ndi kuchuluka kotsatiraku:

voliyumu 0,3 ml - 2850 ME anti-Xa,
voliyumu 0,4 ml - 3800 ME anti-Xa,
buku 0,6 ml - 5700 ME anti-Xa,
voliyumu 0,8 ml - 7600 ME anti-Xa,
1 ml voliyumu - 9500 ME anti-Xa.

Pharmacokinetics

Kutsimikiza kwa katundu wa pharmacokinetic kumakhazikitsidwa ndi kusintha kwa ntchito ya anti-Xa chinthu cha plasma.

Pambuyo pa utsogoleri wa sc, mpaka 88% nadroparin imalowa, ntchito yayitali kwambiri ya anti-Xa (C_max) imafikiridwa mu maola 3-5. Ndi on / kumayambiriro kwa C_max amapezeka osakwana 1/6 a ola limodzi.

Amapangidwira m'chiwindi mokulira mwa kufalikira ndi kuwonongedwa.

T_{1/2 (}kuthetsa theka-moyo) ndi kayendetsedwe ka iv - pafupifupi maola awiri, ndi s / c - pafupifupi maola 3.5. Komanso, anti-Xa ntchito pambuyo pa kukonzekera kwa mlingo wa 1900 ME anti-Xa amalimbikira kwa maola osachepera 18.

Mu okalamba odwala, kusintha kwa mankhwalawa kumapangidwa mogwirizana ndi kukhudzana kwaukalamba kwa thupi la impso.

Fraxiparin ikalembedwera zochizira angina osakhazikika, kulowetsedwa kwa myocardial popanda Q wave kapena thromboembolism mwa odwala omwe amalephera modabwitsa kapena aimpso ndi creatinine chilolezo (CC) kuchokera 30 ml / min mpaka 60 ml / min, mlingo uyenera kuchepetsedwa ndi 25%. Odwala kwambiri aimpso kulephera, poika contraindicated.

Pofuna kupewa thromboembolism mwa odwala omwe amalephera kupweteka kapena aimpso kuchepa kwa mankhwalawa, kuchepa kwa nadroparin sikofunikira, koma kulephera kwambiri kwaimpso, mlingo uyenera kuchepetsedwa ndi 25%.

Kukhazikitsidwa kwa waukulu Mlingo wa ochepa maselo olemera heparin mu ochepa mzere wa dialysis kuzungulira kumalepheretsa magazi kuvala mu dialysis kuzungulira. Ngati bongo waledzera, kudya kwa Fraxiparin mu kufalikira kwampweya kungayambitse kuchuluka kwa ntchito ya anti-Xa chifukwa chogwirizana ndi gawo lomaliza la kulephera kwa aimpso.

Malangizo apadera

Osaba jakisoni intramuscularly!

Panthawi ya chithandizo ndi Fraxiparin, kusinthana kwake ndi mankhwala ena a m'gulu lochepetsa kwambiri maselo a heparin sikuvomerezeka. Izi zimachitika chifukwa chophwanya mtundu wa mankhwala chifukwa mankhwalawa amamwa mankhwala mosiyanasiyana.

Ma syringe omaliza amakupatsani mwayi kuti musankhe mwatsatanetsatane mlingo, poganizira kulemera kwa thupi la wodwalayo.

Zizindikiro za necrosis m'dera la yankho la mankhwalawa nthawi zambiri amakhala phenura, malo owawa a erythematous kapena kulowetsedwa (kuphatikiza Zizindikiro zina). Zikachitika, siyani kugwiritsa ntchito Fraxiparin nthawi yomweyo.

Heparins amachulukitsa chiopsezo cha thrombocytopenia, chifukwa chake chithandizo chikuyenera kuyendetsedwa ndikuwunika mosamala kuchuluka kwa ma cell. Chenjezo makamaka liyenera kuchitika, ndipo ngati zotsatirazi zikuwoneka, chithandizo chiyenera kuyimitsidwa nthawi yomweyo: thrombocytopenia, kuchepa kwakukulu (30-50% ya mtengo woyambirira) wa kuchuluka kwa zinthu zam'magazi, mphamvu zoyipa za thrombosis zomwe zimathandizidwa, komanso thrombosis yomwe idayambika pakukonzekera mankhwalawa , wogawika intravascular coagulation syndrome.

Ngati ndi kotheka, Fraxiparin itha kutumizidwa kwa odwala omwe ali ndi mbiri ya heparin-inachititsa thrombocytopenia yomwe idachitika panthawi yogwiritsa ntchito heparins yopanda mafuta. Pankhaniyi, kuwerengera kwamapulogalamu amasiku onse kumawonetsedwa. Ngati thrombocytopenia ikuchitika, muyenera kusiya kugwiritsa ntchito mankhwalawo ndikuganiza za anticoagulants a magulu ena.

Kukhazikitsidwa kwa Fraxiparin kuyenera kuchitika kokha mutaganizira zotsatira za kuwunika kwa impso.

Poyerekeza ndi kagwiritsidwe ntchito ka heparin mwa odwala omwe ali ndi kuchuluka kwa potaziyamu m'magazi kapena chiwopsezo chowonjezeka cha kuchuluka kwa potaziyamu m'magazi, mwayi wa hyperkalemia ukuwonjezeka. Pankhaniyi, ndi njira yayitali yothandizira kapena kuchiza odwala omwe ali ndi vuto losatha aimpso, matenda a shuga, metabolic acidosis kapena omwe alandila chithandizo chofanana ndi angiotensin akatembenuka mankhwala a enzyme inhibitors (ACE), omwe si a anti -idalidal anti-kutupa mankhwala (NSAIDs) ndi mankhwala ena omwe amathandizira kukulitsa hyperkalemia, ndikofunikira kusamala lawani mulingo wa potaziyamu m'magazi.

Lingaliro la kuthekera kophatikiza anticoagulants ndi neuroaxial blockade limapangidwa payokha kutengera kuwunika kwa kuphatikiza phindu ndi chiwopsezo cha kuphatikiza uku.

Mukamachita opaleshoni ya msana komanso ya m'magazi kapena kuwumba koboola m'mimba, kuyimitsidwa pakati pakukhazikitsa mankhwalawa ndikukhazikitsa kapena kuchotsa kwa singano kapena singano ya cell kapena patheter. Mukamagwiritsa ntchito Fraxiparin popewa thromboembolism, ndi osachepera maola 12, chifukwa cha mankhwala - maola 24. Pakulephera kwa impso, nthawiyo imatha kuchuluka.

Ndi mkhutu aimpso ntchito

Zochizira thromboembolism, osakhazikika angina pectoris kapena myocardial infarction popanda Q wave, makonzedwe a nadroparin calcium solution amatsutsana mwa odwala omwe amalephera kwambiri aimpso (CC osakwana 30 ml / min). Ndi CC ya 30-60 ml / min, mlingo umachepetsedwa ndi 25%.

Mukamagwiritsa ntchito Fraxiparin popewa thrombosis mwa odwala omwe amalephera kupweteka kwa impso, kuchepetsa kwa mankhwalawa sikofunikira ndi CC ya 30-60 ml / min, ndi CC yochepera 30 ml / min - iyenera kuchepetsedwa ndi 25%.

Kuyanjana kwa mankhwala

Ndi munthawi yomweyo kugwiritsa ntchito Fraxiparin:

osagonjetseka kapena otsika maselo olemera heparins, potaziyamu wothandiza okodzetsa, potaziyamu mchere, angiotensin II receptor blockers, cyclosporin, tacrolimus, trimethoprim, ACE inhibitors, NSAIDs: kuonjezera chiopsezo cha hyperkalemia,
Mankhwala omwe amakhudza hemostasis (yosawunjika anticoagulants, dextran, fibrinolytics, acetylsalicylic acid, NSAIDs): amachititsa kuti anthu azigwirizana,
acetylsalicylic acid (pa mlingo wa 50-300 mg wowonetsa zamankhwala kapena zamankhwala
anticoagulants, dextrans, systemic glucocorticosteroids: ayenera kugwiritsidwa ntchito mosamala. Pambuyo pa kayendetsedwe ka anticoagulants osadziwika, kugwiritsa ntchito Fraxiparin kuyenera kupitilizidwa mpaka cholinga cha MHO (International Normalized Ratio) chikwaniritsidwe.

Zofanizira za Fraxiparin ndi izi: Fraxiparin Forte, Atenativ, Fragmin, Wessel Douay F, Kleksan, Heparin, Heparin-Darnitsa, Heparin-Biolek, Heparin-Indar, Heparin-Farmeks, Heparin-Novofarm, Novoparin, Tsibor, Enoks.

Mankhwala

Njira yamachitidwe
Calcium nadroparin ndi heparin yotsika kwambiri ya maselo (LMWH) yotengedwa ndi depolymerization kuchokera ku heparin yodziwika. Ndi glycosaminoglycan yokhala ndi kulemera pafupifupi mamiliyoni pafupifupi 4300 dalton.
Nadroparin amawonetsa kuthekera kwakukulu kumangiriza mapuloteni a plasma ndi antithrombin III (AT III). Kumangiriza kumeneku kumabweretsa kuyendetsa patsogolo kwambiri kwa factor Xa. zomwe zimachitika chifukwa cha kuthekera kwakukulu kwa nadroparin. Njira zina zomwe zimapereka antithrombotic mphamvu ya nadroparin. liphatikize kutsegula kwa minyewa yotulutsa minyewa (TFPI), kutsegula kwa fibrinogenesis potulutsa mwachindunji gawo la plasminogen activator kuchokera ku maselo a endothelial, ndikusinthidwa kwa rheology ya magazi (kuchepa kwa kukhudzika kwa magazi ndi kuchuluka kwa kuphatikizika kwa maphatikizidwe am'magazi ndi granulocyte membranes).

Mankhwala
Nadroparin amadziwika ndi ntchito zapamwamba motsutsana ndi factor XA, poyerekeza ndi zochita motsutsana ndi factor IIa. Imakhala ndi zochita za antithrombotic nthawi yomweyo komanso nthawi yayitali.
Poyerekeza ndi heparin yopanda kukonzekera, nadroparin imakhala yocheperako pakugwira ntchito ya platelet komanso kuphatikiza ndipo imakhudza kwambiri he hetasis ya pulayimale.
Mu Mlingo wa prophylactic, sizimapangitsa kuchepa kutchulidwa kwakanthawi kokhazikika kwa nthawi ya thrombin (APTT).
Ndi njira ya chithandizo munthawi ya zochita zochuluka, APTT imatha kuwonjezeka mpaka mtengo wapatali maulendo 1.4 kuposa muyeso. Kutalika koteroko kumawonetsera otsalira a antithrombotic mphamvu ya calcium nadroparin.

Pharmacokinetics
Facacokinetic katundu amatsimikiza pamaziko a kusintha kwa ntchito ya anti-Xa chinthu cha plasma.
Mafuta
Pambuyo pa subcutaneous makonzedwe, pazipita anti-Xa (C_max) imatheka pambuyo pa maola 35 (T_max).
Bioavailability
Pambuyo pa kayendetsedwe ka subcutaneous, nadroparin imakhala yodzaza kwathunthu (pafupifupi 88%).
Ndi makonzedwe amtsempha, ntchito yayikulu yotsutsa-Xa imakwaniritsidwa osakwana mphindi 10, theka-moyo (T_½ ) ndi pafupifupi 2 maola.
Kupenda
Metabolism imachitika makamaka m'chiwindi (kufalikira, kutsitsidwa).
Kuswana
Hafu ya moyo pambuyo subcutaneous makonzedwe ali pafupifupi maola 3.5. Komabe, ntchito anti-Xa amalimbikira kwa pafupifupi maola 18 pambuyo jekeseni wa nadroparin pa mlingo wa 1900 anti-XA ME.

Magulu owopsa

Odwala okalamba
Odwala okalamba, chifukwa cha kuchepa kwa impso, kuchotsedwa kwa nadroparin kumachepetsa. Kulephera kwa impso m'gululi la odwala kumafunika kuwunikira komanso kusintha koyenera kwa mlingo.

Odwala ndi mkhutu aimpso ntchito
M'maphunziro a zamankhwala pa pharmacokinetics ya nadroparin akaperekedwa mwamphamvu kwa odwala omwe ali ndi vuto laimpso losiyanasiyana, kuphatikiza kunakhazikitsidwa pakati pa kuvomerezeka kwa nadroparin ndi chilolezo cha creatinine. Poyerekeza zomwe zapezedwa ndi zomwe odzipereka athanzi labwino, zidapezeka kuti AUC ndi theka la moyo adachulukitsa mpaka 52-87%, ndikupanga chilolezo cha creatinine mpaka 47-64% ya zinthu wamba. Kafukufukuyu adawonanso kusiyana kwakukulu pamunthu aliyense payekha. Odwala kwambiri aimpso kulephera, theka moyo wa nadroparin ndi subcutaneous makonzedwe kuchuluka kwa 6 maola.Zotsatira za kafukufukuyu zikuwonetsa kuti kuchulukana pang'ono kwa nadroparin kumatha kuwonedwa mwa odwala omwe ali ndi vuto lochepa kapena ochepa aimpso (kulengedwa kwa creatinine kumakhala kwakukulu kuposa kapena kofanana ndi Som / min komanso ochepera 60 ml / min), motero, mlingo wa Fraxiparin uyenera kuchepetsedwa ndi 25% mwa odwala omwe amalandira Fraxiparin zochizira thromboembolism, osakhazikika angina pectoris / myocardial infarction popanda Q wave. Fraxiparin imayikidwa mwa odwala omwe ali ndi vuto lalikulu laimpso, pofuna kuthana ndi mikhalidwe.
Odwala omwe ali ndi vuto lochepa kapena aimpso kulephera, kugwiritsa ntchito Fraxiparin pofuna kupewa thromboembolism, kudzikundikira kwa nadroparin sikupitirira kuti odwala omwe ali ndi vuto laimpso, amatenga mankhwalawa achire a Fraxiparin. Chifukwa chake, kuchepetsa mlingo wa Fraxiparin wotengedwa chifukwa cha prophylactic m'gulu lino la odwala sofunikira. Odwala kwambiri aimpso kulephera kulandira prophylactic fraxiparin, kuchepetsa 25% ndikofunikira poyerekeza ndi Mlingo wolembedwa kwa odwala omwe ali ndi chizolowezi cha creatinine chilolezo.
Hemodialysis
Mochepa heparin wama hematin amayamba mu ochepa mzere wa dialysis kuzungulira muyezo wokwanira kuteteza magazi kuunjikana. Magawo a pharmacokinetic sasintha kwenikweni, kupatulapo vuto la mankhwala osokoneza bongo, pamene kupita kwa mankhwalawo kuzungulira kwa systemic kungapangitse kuwonjezeka kwa ntchito ya anti-Xa chifukwa chogwirizana ndi gawo lomaliza la kulephera kwa aimpso.

Mlingo ndi makonzedwe

Fraxiparin ndi mankhwala opangidwira kukonzekera. Mlingo wa mankhwalawa komanso nthawi yayitali ya chithandizo amatsimikiza ndi dokotala, kutengera mawonekedwe ndi mawonekedwe a thupi la wodwalayo.

Nthawi zambiri, pamtunda wam'mimba kapena ntchafu mumasankhidwa kuti mupeze jakisoni. Khungu limakodwa mumtambo pakati pa chala chakumaso ndi chala ndipo singano imayilidwa pakhungu.

Poletsa kukhazikika kwa thromboembolism pambuyo pakuchita opaleshoni, 0,3 ml ya Fraxiparin imayendetsedwa kwa maola 2-4 musanachite opareshoni, kenako kwa masiku angapo kamodzi patsiku, osachepera masiku 7.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Kugwiritsa ntchito mankhwala Fraxiparin pa nthawi ya pakati sikulimbikitsidwa, popeza zovuta zamankhwala ndizochepa. Mu maphunziro a nyama, mphamvu ya teratogenic kapena embryotoxic ya mankhwala pa mwana wosabadwayo sanakhazikitsidwe, komabe, ngakhale atadziwa izi, mankhwalawa sanalembedwe kwa amayi omwe amakhala ndi mwana. Ngati ndi kotheka, dokotalayo amawunika kuchuluka kwa zomwe zingakhale zabwino ndi zoopsa kwa mayi ndi mwana wosabadwayo.

Panthawi yoyamwitsa, mankhwala a Fraxiparin sanalembedwe kwa mayi, chifukwa sichikudziwika za kuthekera kwa mankhwalawa kuti atulutsidwe mkaka wa m'mawere. Ngati kuli koyenera kupereka jakisoni wa Fraxiparin kwa mayi woyamwitsa, mkaka wa m'mawere uyenera kusokonezedwa ndipo mwana asamutsidwe kupita ku zakudya zosakanikira ndi mkaka wosinthika.

Zotsatira zoyipa

Monga lamulo, mankhwalawa amavomerezedwa bwino ndi odwala, koma nthawi zina, kukulitsa zovuta zoyipa kumatheka:

Kuchokera pakuphatikizika kwa magazi - magazi a kutukuka kosiyanasiyana,
Kuchokera ku ziwalo za hematopoietic - kuchepa kwamapulogalamu ambiri ndi eosinophilia, omwe amadzichititsa okha atasiya mankhwala
Kuchokera chitetezo chamthupi - urticaria, kuthamanga kwa magazi kunkhope, kumva kutentha pamutu, angioedema, dermatitis,
kukulitsa chiwindi, kuchuluka kwa hepatic transaminases,
zimachitika kwanuko - mapangidwe a hematomas a subcutaneous pamalo a jakisoni, mawonekedwe a zopweteka zimalowa pansi pakhungu, redness khungu kuzungulira jekeseni, khungu necrosis pamalowo jakisoni.

Zotsatira zoyipa ngati zikuchitika, muyenera kufunsa dokotala kuti akupatseni malangizo.

Tchuthi ndi malo osungira

Fraxiparin wa mankhwala amaperekedwa kuchokera ku pharmacies ndi mankhwala. Sungani syringes ndi mankhwalawa patali ndi ana, kutali ndi kutentha ndi kuwala. Alumali moyo wa mankhwalawo umawonetsedwa phukusi ndipo ndi zaka 2 kuyambira tsiku lopangidwa.

Osagwiritsa ntchito yankho laukadaulo ngati umphumphu wa phukusi udasokonekera.

Angina pectoris wosakhazikika komanso kulowerera kwa myocardial popanda Q wave

Fraxiparin imayendetsedwa maola 12 aliwonse. Kutalika kwa kugwiritsa ntchito, monga lamulo, ndi masiku 6. Panthawi ya mayesero azachipatala, mankhwalawa adayikidwa limodzi ndi acetylsalicylic acid (325 mg patsiku).

Mlingo woyambirira uyenera kuperekedwa ngati jakisoni wamkati kamodzi, kenako ndi s / c.

Mlingo watsimikiza ndi kulemera - 86 anti-XA IU / kg.

Kupewa kwa kuchulukana kwa magazi mu njira ya kufalikira kwa masana pa hemodialysis

Mlingo wa Fraxiparin amatsimikiza payekha, poganizira luso la dialysis.

Kumayambiriro kwa gawo lirilonse, Fraxiparin iyenera kuyambitsidwa kamodzi mu mzere wakuda wa dialysis kuzungulira. Kwa odwala popanda chiopsezo chowonjezeka magazi, Mlingo woyambirira umakhazikitsidwa kutengera kulemera, koma wokwanira gawo la maola anayi: